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General NPI Number Information
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NPI Number | 1063295822
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Entity Type | Individual
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Provider Name | SAIMA CHISHTI PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 2355 POPLAR LEVEL RD STE 405
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City | LOUISVILLE
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State | KY
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Zip | 40217-1389
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Country | US
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Telephone | 502-636-7845
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Fax | 502-636-8045
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Provider Business Mailing Address
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Address Line | 4612 CHAMBERLAIN LN UNIT 204
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City | LOUISVILLE
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State | KY
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Zip | 40241-1071
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Country | US
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Telephone | 502-425-5556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA3266
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License Number State | KY
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